Posted by Rod Speed on April 18, 2010, 12:17 am
JohnDoe@BadISP.org wrote:
>>>
>>> The fact that a doctor will not disclose costs is sufficient
>>> in my opinion to deny him a license to practice medicine.
>>> These are people, not Gods, they are not allowed to play
>>> under a different set of rules than the rest of us. Not
>>> disclosing costs is dishonest, plain and simple.
>>
>> Well, as someone who has worked in the medical field for 18 years,
>> how much it costs truly depends on what insurance the patient has,
>> assuming that the patient wants to know how much it will cost
>> him/her. And even if the insurance company gives you an estimate of
>> the costs up-front, that doesn't mean that even if they approve the
>> surgery they won't come back after the fact when you submit the
>> claim for it and say, "Sorry, we're not paying for that," and there
>> is not a whole bunch the doc can do except appeal the claim denial
>> and see if he can convince the insurance company to pay for it --
>> which, if they won't, will mean that the patient now will have to
>> pay a lot more to cover what the insurance company reneged on.
> You're probably correct and this is one of the things the recent
> health care reform should have corrected but probably didn't. It's
> disgraceful and really not understandable why the courts won't
> intervene and stop these practices. If you ask for your car to be
> repaired and the garage gives you a quote that's the maximum
> they can collect. Why should the human/doctor be any different?
Essentially because its nowhere near as easy to predict
what total services the individual needs with a serious
medical problem, like for example when the individual
ends up with a very serious infection that costs a hell
of a lot to fix. You dont get anything like that with cars.
> The MD should provide a quote in writing after asking the insurance
> company. If later on they renege (or so he says) he (the MD) eats it!
It cant work like that with major surgery. There is always the possibility
of a very serious infection or even once the individual is opened up, the
surgeon discovers that the individual has a much more complicated
physiology than was expected or even an early cancer etc.
> BTW that's how it works for my dentist.
No it doesnt. If you do develop a serious infection as the
result of say a crown, he does not fix that entirely at his cost.
> He says (say) he's got to put
> in a crown at [tooth number]; he sends all the paperwork and x-rays to
> the insurance company and they approve in advance in writing telling
> him how much he has to collect from me (the customer). He says he's
> never had a problem with the insurance company not paying later on and
> if they didn't he would consider that between him and them, nothing he
> could recharge to the customer.
But likely did have a problem when a patient got an infection etc.
Posted by Gordon Burditt on April 18, 2010, 12:34 am
>> You're probably correct and this is one of the things the recent
>> health care reform should have corrected but probably didn't. It's
>> disgraceful and really not understandable why the courts won't
>> intervene and stop these practices. If you ask for your car to be
>> repaired and the garage gives you a quote that's the maximum
>> they can collect. Why should the human/doctor be any different?
>Essentially because its nowhere near as easy to predict
>what total services the individual needs with a serious
>medical problem, like for example when the individual
>ends up with a very serious infection that costs a hell
>of a lot to fix. You dont get anything like that with cars.
You can get something like that with cars. For example, you bring
in the car, badly overheating, and they diagnose it as a cracked
radiator, and quote you a (large) price. (Up to this point, this
really happened. Yes, the crack was real; I pointed it out to
them.) *LATER*, after they've fixed the radiator, they try to test
the engine and discover that the block is cracked from severe
overheating due to the cracked radiator. (What really happened
here was they tested the engine and decided it wasn't harmed by the
overheating. Apparently repeatedly stopping and refilling the
radiator with water helped prevent damage while limping home.)
They'll stick to their quote on fixing the radiator, but they won't
include a free replacement engine block in the deal.
It isn't that unusual to discover that one part failing takes out
another part also (on both cars and humans).
Posted by Samantha Hill on April 19, 2010, 3:15 am
Rod Speed wrote:
>
> Essentially because its nowhere near as easy to predict
> what total services the individual needs with a serious
> medical problem, like for example when the individual
> ends up with a very serious infection that costs a hell
> of a lot to fix. You dont get anything like that with cars.
Actually, I did once. I hit something on the freeway at night with my
car and it did a lot of damage to my engine, and they really couldn't
see everything that was wrong until they started getting in there and
taking everything apart.
Other than that, I think you are spot-on.
Posted by Rod Speed on April 19, 2010, 5:49 am
Samantha Hill wrote
> Rod Speed wrote
>> Essentially because its nowhere near as easy to predict
>> what total services the individual needs with a serious
>> medical problem, like for example when the individual
>> ends up with a very serious infection that costs a hell
>> of a lot to fix. You dont get anything like that with cars.
> Actually, I did once.
Nope.
> I hit something on the freeway at night with my car and it did a lot of damage
to my engine, and they really couldn't
> see everything that was wrong until they started getting in there and taking
everything apart.
Thats nothing like a serious problem that was
PRODUCED by the attempt to fix the car.
Thats closer to the other situation where, once they open
the patient up, they discover that the individual has cancer
and that wasnt obvious when they quoted for surgery for
a completely different problem.
> Other than that, I think you are spot-on.
Posted by JohnDoe on April 19, 2010, 10:59 am
>JohnDoe@BadISP.org wrote:
>> You're probably correct and this is one of the things the recent
>> health care reform should have corrected but probably didn't. It's
>> disgraceful and really not understandable why the courts won't
>> intervene and stop these practices. If you ask for your car to be
>> repaired and the garage gives you a quote that's the maximum
>> they can collect. Why should the human/doctor be any different?
>Essentially because its nowhere near as easy to predict
>what total services the individual needs with a serious
>medical problem, like for example when the individual
>ends up with a very serious infection that costs a hell
>of a lot to fix. You dont get anything like that with cars.
Yes you do. In your case the infection could have been caused by the
intervention (e.g. the problem of MRSA) where it's analogous to the
mechanic, after making repairs to the engine, testing your car without
putting oil in the engine. The engine seizes up and usually the
mechanic is liable for the damage he caused. Alternatively if he can
show it wasn't his fault he can escape the cost of the new engine and
ask the owner what he (the owner) wants to do.
In any event, if the patient (how I hate that demeaning word) is able
to make a decision on his own (he's conscious and of sound mind) the
MD asks him and as part of the asking he tells the patient exactly how
much it is going to cost. How much will be paid by the insurance, how
much by the patient, how much by the malpractice lawsuit. Except for
the cost aspect he has to do this anyway under the doctrine of
informed consent.
If the patient is non-compos-mentis, and the surgery is elective, the
patient should have appointed a person to act on his behalf (same
informed consent doctrine). All that has to be done is to extend that
to "How much, buddy."
Only for emergency surgery would there be any excuse for not providing
a quote in advance and the options to decline etc.
>> The MD should provide a quote in writing after asking the insurance
>> company. If later on they renege (or so he says) he (the MD) eats it!
>It cant work like that with major surgery. There is always the possibility
>of a very serious infection or even once the individual is opened up, the
>surgeon discovers that the individual has a much more complicated
>physiology than was expected or even an early cancer etc.
You keep going on about this serious infection etc, but in these cases
in elective surgery the patient should have made his decisions in
advance. In any event I'd settle for a quote for uneventful surgery
until the MD's are whipped into line.
>> BTW that's how it works for my dentist.
>No it doesnt. If you do develop a serious infection as the
>result of say a crown, he does not fix that entirely at his cost.
Huh? On about this serious infection again. If you develop some
infection as a result of his setting of the crown the dentist should
be worried about lawsuits, not the minor cost of antibiotics.
>> He says (say) he's got to put
>> in a crown at [tooth number]; he sends all the paperwork and x-rays to
>> the insurance company and they approve in advance in writing telling
>> him how much he has to collect from me (the customer). He says he's
>> never had a problem with the insurance company not paying later on and
>> if they didn't he would consider that between him and them, nothing he
>> could recharge to the customer.
>But likely did have a problem when a patient got an infection etc.
Oh, get off the infection kick. Only in abnormal circumstances would
the dentist not know this in advance (e.g. an abscess) and treat it
separately before putting in a crown. The insurance would also pay
separately.
XML site map
>>> The fact that a doctor will not disclose costs is sufficient
>>> in my opinion to deny him a license to practice medicine.
>>> These are people, not Gods, they are not allowed to play
>>> under a different set of rules than the rest of us. Not
>>> disclosing costs is dishonest, plain and simple.
>>
>> Well, as someone who has worked in the medical field for 18 years,
>> how much it costs truly depends on what insurance the patient has,
>> assuming that the patient wants to know how much it will cost
>> him/her. And even if the insurance company gives you an estimate of
>> the costs up-front, that doesn't mean that even if they approve the
>> surgery they won't come back after the fact when you submit the
>> claim for it and say, "Sorry, we're not paying for that," and there
>> is not a whole bunch the doc can do except appeal the claim denial
>> and see if he can convince the insurance company to pay for it --
>> which, if they won't, will mean that the patient now will have to
>> pay a lot more to cover what the insurance company reneged on.
> You're probably correct and this is one of the things the recent
> health care reform should have corrected but probably didn't. It's
> disgraceful and really not understandable why the courts won't
> intervene and stop these practices. If you ask for your car to be
> repaired and the garage gives you a quote that's the maximum
> they can collect. Why should the human/doctor be any different?